Late onset of biliobronchial fistula - a serious complication of hemihepatectomy for atrophic liver with hepatolithiasis: a case report and review of the literature.

Background: Acquired bronchobiliary fistula (BBF) is a rare but life-threatening complication that can occur as a result of oncological processes, inflammatory reactions, parasite infections, thoracoabdominal trauma, or invasive procedures associated with iatrogenic injury. However, the potential etiology of BBF caused by instrumental issues when using ultrasonic scalpels resulting in diathermy burn and its post-burn effects has never been reported.

Case Presentation: Herein, we present a case of a 65-year-old woman who developed BBF one month after hepatectomy and presented with refractory irritating cough accompanied by yellow bitter sputum.

Thoracobiliary Fistula Complications Following Concomitant Diaphragm and Liver Injury.

Introduction: Thoracobiliary fistula (TBF) is a rare and highly morbid complication of hepatic trauma. There is a paucity of literature regarding incidence, disease course, and treatment. This study identifies etiologic factors and outcome patterns in patients at risk for TBF.

Right upper quadrant pain after previous blunt abdominal trauma: undiagnosed traumatic diaphragmatic hernia with strangulated right colon.

A woman in her 40s self-presented to an emergency department in a major trauma centre with severe right-sided abdominal pain, a tender right upper quadrant mass and chest pain. Diagnostic imaging showed a previously undiagnosed diaphragmatic hernia containing strangulated right colon. The patient had been the victim of a high-energy road traffic accident 18 months earlier, but at that time had not presented to hospital or undergone any outpatient investigation.

Serial sonographic assessment of diaphragmatic atrophy and lung injury patterns in mechanically ventilated preterm infants to predict extubation failure: a prospective observational study.

Unlabelled: Diaphragmatic atrophy (DA) and lung injury (LI) have been associated with mechanical ventilation (MV). We aimed to assess the ultrasonographic changes in diaphragmatic thickness and LI during MV and their prediction for extubation failure in preterm infants. In this prospective observational study, mechanically ventilated preterm infants, < 30 weeks gestation, within the first 24 h of life underwent a baseline, within 24 h of MV, and serial diaphragmatic and lung ultrasounds scans until their first extubation attempt.

Traumatic pancreatic injuries and treatment outcomes: An observational retrospective study from a high-volume tertiary trauma center.

Introduction: This study discusses a tertiary trauma center's experience involving traumatic pancreatic injuries, focusing on identification, management, and complications, aiming to provide a valuable contribution to the literature on pancreatic trauma management.

Methods: We conducted a five year (2019-2023) retrospective analysis utilizing trauma registry data to identified pancreatic injuries in tier 1 and 2 activations. Pancreatic Organ Injury Scaling (OIS) and overall injury severity (ISS) was assessed using AAST scoring.

Challenges in Transitioning from Controlled to Assisted Ventilation in Acute Respiratory Distress Syndrome (ARDS) Management.

Acute respiratory distress syndrome (ARDS) presents significant challenges in critical care, primarily due to its inflammatory nature, which leads to impaired gas exchange and respiratory mechanics. While mechanical ventilation (MV) is essential for patient support, the transition from controlled to assisted ventilation is complex and may be associated with intensive care unit-acquired weakness, ventilator-induced diaphragmatic dysfunction and patient self-inflicted lung injury. This paper explores the multifaceted challenges encountered during this transition, with a focus on respiratory effort, sedation management, and monitoring techniques, and investigates innovative approaches to enhance patient outcomes.

Surgical treatment for complete resection of transthoracic and abdominal schwannoma with diaphragm invasion using the transthoracic approach: a case report and literature review.

Background: The removal of schwannomas involving the chest and abdominal cavities is difficult, which requires a high level of overall proficiency and technical expertise from surgeons. Therefore, this study explored a safe and feasible surgical method for the complete resection of this type of tumor.

Methods: We collected the medical records of a 44-year-old female patient with space-occupying lesions near the thoracic vertebrae.

Complex Organ Injury Management in Abdominal Trauma: Case of a Heavy Iron Plate Accident.

BACKGROUND Open injury of multiple organs in the chest and abdomen, such as the colon, duodenum, kidney, liver and diaphragm, is relatively rare. The rescue of such a patient is difficult, and the results are often unsatisfactory. It is also a challenge for the hospital and doctors.

[Delayed Massive Hemothorax due to Non-absorbable Sutures Tips Used in Diaphragm Reconstruction for Thymoma Dissemination].

A 57-year-old man underwent partial resection of the right diaphragm with invasive thymoma dissemination. Fifteen days after surgery, he suddenly developed right-sided chest pain with dyspnea and was raced to the hospital. Chest computed tomography (CT) showed a massive right hemothorax, and emergency surgery was performed due to hemodynamic shock.

Non-contact sensor module for rapid detection of extravasation during intravenous drug administration.

Intravenous drug administration delivers medication directly into the bloodstream, providing rapid and controlled effects, making it highly beneficial for emergencies or when immediate drug action is required. However, several risks are associated with intravenous drug administration, including infiltration and extravasation, which can lead to serious complications due to the rapid absorption of medication to the surrounding tissues. To prevent complications, here we proposed a non-contact sensor module to rapidly detect such events.

Unraveling the mysteries of parsonage turner syndrome: A journey towards optimal management. A systematic review.

Aims: Parsonage Turner Syndrome (PTS) is a peripheral neuropathy manifesting as sudden onset pain, muscle weakness, and atrophy. This review aims to analyse long-term outcomes reported in adult patients with PTS, and establish an optimised management approach.

Methods: A comprehensive literature search was performed using MEDLINE, PubMed, and the Cochrane Library.

A Rare Case of Intraperitoneal Infection by Kodamaea ohmeri.

Background: In April 2024, our hospital confirmed a rare case of intra-abdominal infection by Kodamaea ohmeri. The patient sought medical attention at our hospital after taking painkillers orally for one month, experiencing recurrent abdominal pain for 17 days and worsening for 7 days. In March 2024, the patient received symptomatic treatment with oral analgesics (diclofenac sodium) for arthritis.

The Natural History of Dermatosparaxis Ehlers Danlos Syndrome: An Adult Case Series.

Dermatosparaxis Ehlers Danlos syndrome (dEDS) is a very rare monogenic EDS that occurs due to biallelic pathogenic variants in ADAMTS2. Fifteen individuals with dEDS have been reported in the literature, with the oldest being 19 years at follow-up. Given the lack of information regarding adults with dEDS, our aim was to describe adults with dEDS to inform management recommendations in adulthood.

Diaphragm pacing compared with mechanical ventilation in patients with chronic respiratory failure caused by diaphragmatic dysfunction: a systematic review and meta-analysis.

Background: The effectiveness of diaphragmatic electrical stimulation (DES) compared to mechanical ventilation (MV) in improving clinical outcomes such as quality-of-life (QOL) and hospital stay remains inconsistent.

Methods: We conducted a systematic review and meta-analysis by searching PubMed, Scopus, Google Scholar, LILACS, and IEEE Xplore. We included comparative studies (randomized controlled trials and observational studies) of DES administered via the phrenic nerve or intramuscular electrodes, compared with MV in adults with diaphragmatic paralysis or paresis.

A Cadaver Study: The Relationship of Vital Organs of the Thoracolumbar Junction During a far Lateral Approach Using a T-12 Corpectomy Model.

Study Design: Human cadaver study.

Objectives: To provide a qualitative and quantitative evaluation by demonstrating measurements of the proximity of vital structures involved and assessed injuries during a T12-corpectomy and cage implantation via a far lateral approach.

Material And Methods: Six fresh-frozen adult cadaveric specimens were dissected according to standardized protocol.

Endoscopic transsphenoidal surgery for infradiaphragmatic craniopharyngiomas and impact of diaphragm sellae competence on hypothalamic injury.

Investigate the impact of diaphragm sellae competence on surgical outcomes and risk factors for postoperative hypothalamic injury (HI) in patients undergoing endoscopic transsphenoidal surgery (ETS) for infradiaphragmatic craniopharyngiomas (ICs). A retrospective analysis of 54 consecutive patients (2016-2023) with ICs treated by ETS was conducted. All tumors originated from the sellar region inferior to the diaphragm sellae and were classified into two subtypes in terms of diaphragm sellae competence: IC with competent diaphragm sellae (IC-CDS) and IC with incompetent diaphragm sellae (IC-IDS).

The anatomical distribution of penetrating junctional injuries and their resource implications: A retrospective cohort study.

Background: There is no standardised definition of what constitutes a junctional injury. Although well described in military literature, this is not the case in the civilian setting. This study aims to characterise the epidemiology of the civilian penetrating junctional injuries in our centre.

How to protect the diaphragm and the lung with diaphragm neurostimulation.

Purpose Of Review: In the current review, we aim to highlight the evolving evidence on using diaphragm neurostimulation to develop lung and diaphragm protective mechanical ventilation.

Recent Findings: Positive-pressure ventilation (PPV) causes stress and strain to the lungs which leads to ventilator-induced lung injury (VILI). In addition, PPV is frequently associated with sedatives that induce excessive diaphragm unloading which contributes to ventilator-induced diaphragmatic dysfunction (VIDD).

Mechanistic Insights Into Redox Damage of the Podocyte in Hypertension.

Podocytes are specialized cells within the glomerular filtration barrier, which are crucial for maintaining glomerular structural integrity and convective ultrafiltration. Podocytes exhibit a unique arborized morphology with foot processes interfacing by slit diaphragms, ladder-like, multimolecular sieves, which provide size and charge selectivity for ultrafiltration and transmembrane signaling. Podocyte dysfunction, resulting from oxidative stress, dysregulated prosurvival signaling, or structural damage, can drive the development of proteinuria and glomerulosclerosis in hypertensive nephropathy.